Inspection on 05/12/05 for Priory Paddocks Nursing Home

This inspection was carried out on 5th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Priory Paddocks Nursing Home 15/11/06

Priory Paddocks Nursing Home 26/09/05

Priory Paddocks Nursing Home 10/03/05

Priory Paddocks Nursing Home 01/09/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Priory Paddocks Nursing Home Priory Lane Darsham Saxmundham Suffolk IP17 3QD Lead Inspector Helen Fontaine Unannounced Inspection 5th December 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Priory Paddocks Nursing Home Address Priory Lane Darsham Saxmundham Suffolk IP17 3QD 01728 668244 01728 668306 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Andrew Burgess Miss Marian Lloyd Miss Marian Lloyd Care Home 37 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (37) of places Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 2005 Brief Description of the Service: Priory Paddocks, previously an Edwardian country house, was converted into a nursing home in 1987 by its present owners, who jointly manage the home. It is situated in the village of Darsham, near the A12 and the local railway station. Village amenities include a public house, a garage and a shop. The home is located next to a farm and is set in two acres of landscaped gardens with a summerhouse and ample parking. During the summer months, residents can take advantage of the patio areas overlooking the gardens. Residents can access all areas of the home and gardens via a stairwell, ramps and a passenger lift. The accommodation consists of twenty-three single bedrooms (twelve with ensuite facilities), seven shared bedrooms (three with en-suite facilities) and assisted bathrooms and toilets. Communal space includes two lounges and a dining room. The home has been decorated throughout in keeping with its original style. The two lounges and dining room evidenced many period features, which lent themselves to creating a warm and homely atmosphere. Pets are welcome at the home, which holds two ‘Cinnamon National Pet Friendly Awards’. The home has its own twelve-seated mini bus, with a battery-operated tailgate, which enables easy access for wheel chair users. The bus is regularly used to take residents on trips and outings. The home is co-owned and jointly managed by Miss Marian Lloyd (Registered Nurse) and Mr Andrew Burgess (Registered Nurse). Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Priory Paddocks Nursing Home, took place over four and a half hours and was the second statutory inspection visit in the inspection programme for 2005/6. Over the course of the two visits, all core standards have now been assessed. No requirements were set at the previous inspection. No requirements but two recommendations were identified at this inspection. The registered provider was present during the inspection and his support was very much appreciated. A tour of the home and the kitchen was undertaken, most areas of the home were seen and two resident’s rooms were looked at. A member of staff and a number of residents were spoken to during the tour. Two of the residents were spoken to individually during the inspection and their co-operation was very much appreciated. What the service does well: The home has an ethos of encouraging activities and continuing with activities the residents took part in before they entered the home. One resident still went out with their family member for a meal occasionally. A member of staff spoken to commented that one of the areas they enjoyed was taking residents out for trips. Another resident said they had a phone connected to their room so they could keep in phone contact with their family member abroad. Although none were seen during the inspection, the home encourages residents to bring their pets in with them. The home also has a lovely flock of resident chickens; these were seen wandering around the grounds. The home encourages independence as much as possible and this was noted in the residents individual Nursing Plans. Each of the residents Nursing Plans are kept in their rooms, which allows the resident to be fully involved in their care. The Nursing Plan was very in depth and covered all the areas of assessed need for each resident. The home has very good policies, procedures and practices for dealing with concerns and complaints. The registered Provider said the few complaints they had were used as a learning exercise. The two residents and the member of staff spoken to said that if they had any concerns they would be looked into. Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Residents referred solely for intermediate are helped to maximise their independence and return home. EVIDENCE: The home does not fill a room that has been vacated by a permanent resident, immediately and uses that room for intermediate care. Some files of residents taking up this opportunity were looked at, one such resident was in hospital and their time in the home would help assess what support would be needed when they returned home. The home works very closely with the families and the social worker if there is one, to make sure that there is a suitable package in place. One resident who come into the home for a short stay was not eating and had an infection. The nursing plan showed that the home encouraged the resident to eat a balanced diet and gave support to make sure their medication was taken. The nursing plan documented that at the time the resident went home, the infection had been cleared up, they were able to self care with personal care and they were less anxious. Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 9 The registered Provider was clear that all residents who came in for short breaks, had to return home as their were other people waiting to come into the home. Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 8 Health and personal care is provided in an individual and well planned manner. EVIDENCE: During the inspection the care plan, called the nursing plan was looked at and found to be detailed and in depth. The nursing plan is kept in each of the resident’s rooms and allows them to have access to read it anytime they want to. All the nursing plans are kept in a folder, with the documents in individual clear plastic sleeves. The first document was for personal details, date of birth, marital status, religion and present medical problems. One resident’s nursing plan looked at, documented their religion and in discussion with the inspector, talked about how they had a visit from the Church and how important this was for them. The personal details then had a section for three different next of kin; on one nursing plan all three had been completed, on another only one. The name of the key worker was also on the personal details, with the resident’s room number. The nursing plan had risk assessments; these were set out in headings of description of risk and action. One of the risk assessments was for a resident who went out with their family member. The description for one area was Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 11 finding their way and car the breaking down. The action was for the resident to inform the home of any trips and the route they would be taking. The nursing plan had a section for life history and covered areas of, place of birth, preferred language, wedding anniversaries and where the ceremony took place. This section also covered areas of preferences and routines and what newspapers they liked. With this and other information around family details and hobbies, the home had a good understanding of the social needs of their residents. The next section of the nursing plan was divided into such headings of personal hygiene, mobility, elimination, diet, social care and dying and religion. Each of the sections then had a description of the need and a section headed action. In another nursing plan looked at, the resident had risk of developing pressure sores and the action was documented as changing and encouragement with changing positioning, done regularly. The nursing plans were based on an assessment of individual need and reviewed regularly, which was signed and dated. It was clear from the availability of the nursing plan to the resident and the discussions with them that they fully understood what was written in their plan. The home is a nursing home and on duty are qualified nurses at all times, the manager and the registered provider are both qualified nurses. In addition to this nursing support the residents have access to a GP and hospital visits when necessary. The home does not rely on hospital transport for this and uses their own transport, which makes accessing appointments much easier. In addition to the nursing plan, each resident has a file for the ‘daily recording’ kept at what the home call the nerve centre. The daily record, records when a resident is unwell and when GP’s visited and when the residents have aromatherapy. The daily record file has a photo of the resident and details of their medication. Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This area will be examined in more detail in future inspections. These standards have been previously assessed as well met, and during the inspection no concerns were raised or noted. EVIDENCE: The above standards were not specifically tested on this visit, as there were no outstanding requirements in relation to the above standards. At the time of the last inspection, all of the outcome standards were assessed as met. These standards will be re-tested at a future inspection. Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 People who use this service can expect that any complaint will be taken seriously and investigated. EVIDENCE: The residents spoken to during the inspection were both happy living at the home. When asked about complaints or concerns, they both said that they would tell the manager or the registered provider. The residents were very confident that any concern or complaint would be dealt with and investigated thoroughly. One resident was quite surprised at the thought that there would be a complaint and said, “It would shake him” (meaning the registered provider) that there was something wrong. It was seen during the tour of the home that the complaints policy is displayed in two places in the home. The homes policy gives information about how to contact the Commission for Social Care Inspection and details that complaints will be responded to in 14 days. The policy also gives details on how to contact the local Government Ombudsman. One complaint was looked at, which came via email was responded to well within the 14 days. The home had written statements from three members of staff and the registered provider said that they use all complaints as a learning exercise. It was noted that there were only two complaints for the current year 2005 and the home must be complimented on their practices around complaints. Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The home provides a good standard of accommodation that is well maintained. EVIDENCE: The home is situated in a beautiful setting in grounds that are kept tidy, attractive and accessible. There were some chickens wandering around the grounds, along with a pond and good views across farmland. The actual house itself has been adapted very sensitively to meet the needs of the residents, but maintaining the architecture of the building. There is a lift and a stair lift and had bedrooms on the first floor and the ground floor. One resident was particularly benefiting from being moved to a ground floor room, where they could see across the grounds. The house was very well maintained and tastefully decorated, with two lounges and a dinning room. During the inspection a tour of the home was made, there were no breaches of regulations around fire doors. The maintenance book was looked at; all the day-to-day maintenance was up to date which included the Chicken Hutch. Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 15 The inspector checked the water by running the tap and it was felt to appropriate. The registered provider said they checked the water each week, but did not keep a written record. It has been suggested to the registered provider that a written record of the weekly water temperatures should be kept. This will evidence that they are being kept and be an indication to the home if the water temperature valves are not regulating it accurately. During the inspection the Environmental report, the fire inspection certificate and the certificate for fire extinguishers were seen. Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This area will be examined in more detail in future inspections. These standards have been previously assessed as well met, and during the inspection no concerns were raised or noted. EVIDENCE: The above standards were not specifically tested on this visit, as there were no outstanding requirements in relation to the above standards. At the time of the last inspection, all of the outcome standards were assessed as met. These standards will be re-tested at a future inspection. Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 38 This home is well managed and there are clear systems in place to protect service users. EVIDENCE: The manager of the home was not present during the inspection, however the registered provider was present. The manager and the provider are both registered with the Commission of Social Care Inspection and both work very closely together. They are very committed to the best possible care for their residents, continuing to explore how they can continue to improve the quality of care and support to staff. The home undertakes a quality assurance and quality monitoring system, the home’s procedure was looked at. The home’s procedure is called an audit development and each resident completes a questionnaire divided into seven areas. Outside, physical internal environment, internal cleanliness, quality of Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 18 staff, delivery of care, catering services and communication. These questions are scored out of five and are totalled at the end. The last audit was in August 04, a cross section of the residents responses were looked at and it was noted that in most areas the home scored 4 or 5 out of 5 and there were additional complimentary comments. This same process is undertaken with staff and this exercise was done in August 05. The home scored 60 , 70 and 80 with this exercise and it was noted that the whole exercise had been documented in a very professional way. The home has a policy of not charging residents for extras; their fee covers everything including hairdressing and aromatherapy. Families or the Local Authority are responsible for the resident’s financial affairs and the home keeps, for those unable, small amounts of money. The home has this in named envelopes; along with any jewel the resident’s want kept safe, in the homes safe. Each resident then has a card in a cardex box, with what is in the envelope and anything added or removed. One envelope was looked at and checked with the cardex and found to be correctly documented. The registered provider said that residents do have their own money, which the home has no involvement with if they are able to. During the tour of the home, all the rooms and bathrooms had hoists. The nursing plans looked at had a section on moving and handling and documented when two staff were needed. There were moving and handling risk assessments in place for all residents needing assistance with mobility. It was noted during the tour, that in some of the bathrooms and toilets the sink plugs were missing. This is a small point but if a member of staff or a resident wished to draw a basin of water, they would not be able to do so. The home’s policies and procedures for control of substances hazardous to health, emergency first aid, fire safety, food handling, infection control, security and general health and safety were looked at. The procedure in the event of the lift breaking down and the signed authorisation for the use of bed sides were also seen. Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 4 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP38 OP38 Good Practice Recommendations The home should consider recording the weekly water temperature check. The home should make sure that all sinks and basins have a plug. Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Priory Paddocks Nursing Home DS0000024475.V271486.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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